Health Anxiety: Is It Really All in Your Head?

Q

What’s normal when it comes to worrying about my health? My fears about getting sick have my stomach in knots all the time, and seeing my doctor doesn’t help for more than the time I’m in the exam room.

It’s natural to worry about your health from time to time. For most people, a doctor visit with a clean bill of health is enough to put their mind at ease. But for those who have ongoing anxiety about their health, a condition appropriately called health anxiety, a doctor’s reassurance is short-lived or rings hollow and they continue to worry (and may continue to go to doctors for reassurance again and again). In severe cases, the anxiety can spiral out of control and take over the person’s life, says psychologist Erik Andersson, PhD.

Mental health professionals distinguish two forms of  health anxiety—somatic symptom disorder and illness anxiety disorder. Together they’re estimated to affect just 3% to 4% of people worldwide, yet they make up a very high percentage of doctor visits—20% of people who seek medical care are anxious about their health.

With somatic symptom disorder, some people feel real physical symptoms like pain or fatigue and then worry excessively that something extremely serious is causing them. Others misinterpret normal body sensations, such as an occasionally fast heartbeat, as dangerous signs of illness. They imagine worst-case scenarios—for instance, that any headache is a sign of a brain tumor. They may spend hours on the Internet learning about brain tumors and convince themselves they indeed have one.

With illness anxiety disorder, people are preoccupied with the idea of getting sick but might not feel any physical symptoms. They may talk about illness a lot, worry about catching infectious diseases they’ve read about in the news, and avoid situations that could sicken them such as visiting a loved one in a hospital. They may repeatedly check their bodies for signs of illness, noticing (and overreacting to) every skin blemish, lump and bump.

What’s worse is that the anxiety can ultimately cause physical symptoms such as dizziness, tightness in the chest, tingling in hands and feet and more, and people experiencing these symptoms may not realize they are anxiety-related, fueling their worries over physical illnesses even more.

If you’re living with either type of health anxiety, you don’t need to suffer. Treatment can help you regain control over your fears. According to Dr. Andersson, it is vital to seek psychological help if the amount of time you are spending worrying about your health is keeping you from truly living your life. Example: Instead of talking to your spouse and children at dinner, you are glued to your smartphone reading about symptoms.

How Treatment Helps

Health anxiety is often treated much as a phobia would be—with a form of cognitive behavioral therapy (CBT). Imagine that you’re afraid of dogs. Every time you see one, you run away and get temporary relief—this is called a safety or avoidance behavior. It may sound counterintuitive, but the treatment for dog phobia is for you to be around dogs. The more you’re exposed to them and see that nothing bad happens, the more you learn that (most) dogs aren’t dangerous.

For treating health anxiety, the idea is to deliberately expose yourself to thoughts of illnesses and symptoms and then to avoid safety behaviors. The approach might sound frightening at first, but you’re guided by a professional who’s trained in the practice and who is next to you to offer support and reassurance as you move through the exercises.

A classic example: You run up a flight of stairs to deliberately make your heart beat faster. This could trigger thoughts that something is wrong with your heart! But instead of calling an ambulance (a safety behavior), you stay in the moment—aware of the fearful thoughts—and see what happens. Facing your fears in this way eventually teaches you that what you feared isn’t happening in reality.

CBT usually is shorter in duration than other forms of therapy—psychoanalysis, for example, can take years, while the average number of CBT sessions for anxiety about health is 10 to 15. Each person and his/her therapist will decide together when formal therapy is no longer needed.

Resources to find a CBT therapist:

• Association for Behavioral and Cognitive Therapies
• National Association of Cognitive-Behavioral Therapists
• Academy of Cognitive Therapy

In addition to CBT, reducing stress will help you manage your anxiety and feel happier. Relaxation techniques can reduce your blood pressure and heart rate, relax tense muscles and calm your mind. Consider…

• Belly breathing. This is a simple technique that you can do just about anywhere. Basically, you train yourself to use the muscle below your lungs—your diaphragm—to take deep, slow breaths. Learn the technique here.
• Guided imagery. With this mind-body technique, you guide your mind to pictures of pleasant images or soothing scenes to replace negative thoughts. You might be on a sunny beach with your toes in warm sand, listening to the waves, smelling the salty air.
• Mindfulness meditation. This involves focusing on your breathing and bringing your attention to the here and now—and not getting bogged down with mistakes of the past or concerns about the future.